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Cost kidney stone

Ben H Chew, Dirk Lange
Open ureterolithotomy and pyelolithotomy used to be first line therapy for treating kidney and ureteral stones. With the advent of shockwave lithotripsy, open stone surgery became less prevalent, but once ureteroscopy became more prevalent, open stone surgery became all but extinct. Advances in smaller, more flexible endoscopes and improvements in intracorporeal lithotripters, ureteroscopy has become a mainstay of therapy for kidney stones. The holmium:YAG laser can be utilized through flexible instruments and fragments any stone no matter what it is composed of...
October 19, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Sacha L Moore, Ewa Bres-Niewada, Paul Cook, Hannah Wells, Bhaskar K Somani
INTRODUCTION: Kidney stone disease is increasing worldwide with its most common location being in the lower pole. A clear strategy for effective management of these stones is essential in the light of ever increasing choice, effectiveness, and complications of different treatment options. MATERIAL AND METHODS: This review identifies the latest and clinically relevant publications focused on optimal management of lower pole stones. RESULTS: We present an up-to-date European Association of Urology and American Urological Association algorithm for lower pole stones, risks and benefits of different treatments, and changing landscape with the miniaturization of percutaneous stone treatments...
2016: Central European Journal of Urology
Ankur Jhanwar, Ankur Bansal, Satyanarayan Sankhwar, Manoj Kumar, Gautam Kanodia, Gaurav Prakash
OBJECTIVE: To analyse outcomes of holmium laser and pneumatic lithotripsy in treatment of lower ureteric calculus in pediatric patients. MATERIALS AND METHODS: Prospective study conducted between August 2013 and July 2015. Inclusion criteria were lower ureteric calculus with stone size ≤1.5cms. Exclusion criteria were other than lower ureteric calculus, stone size ≥1.5cms, congenital renal anomalies, previous ureteral stone surgery. Patients were divided into two groups...
September 1, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
R Orozco Fariñas, J I Iglesias Prieto, P Pellejero Pérez, J Massarrah Halabi, J M Mancebo, E Pérez-Castro Ellendt
OBJECTIVE: The aim of the present article is to summarize the results we obtained treating children with urolithiasis over the last 30 years and to perform an analysis on the basis of the these results and relevant details according to national and international experience. METHODS: Retrospective and descriptive statistical analysis of the 30 year experience in our clinics. The study was performed with a sample size of 178 children treated with urolithiasis that underwent 221 procedures...
September 2016: Archivos Españoles de Urología
Christopher J Kirwan, Kelly Wright, Peter Banda, Aylwin Chick, Mwayi Mtekateka, Enos Banda, Zuze Kawale, Rhys Evans, Hamish Dobbie, Gavin Dreyer
BACKGROUND: Acute kidney injury is common and has significant impact on mortality and morbidity. There is a global drive to improve the lack of knowledge and understanding surrounding the recognition, diagnosis and management of patients with AKI in resource poor healthcare systems. OBJECTIVES: We propose a nurse-led education programme to medical and nursing staff of the Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, will improve the overall care and understanding of patients with AKI that will still be effective 3 months later...
September 5, 2016: Journal of Renal Care
Raymond J Leveillee, Emily Fell Kelly
BACKGROUND: Since the development of the first flexible ureteroscope, in 1964, technological advances in image quality, flexibility, and deflection have led to the development of the first single-use digital flexible ureteroscope, LithoVue™ (Boston Scientific, Marlborough, MA). With respect to reusable fiber-optic and now digital ureteroscopes, there is an initial capital cost of several thousand dollars (USD) as well as, controversy regarding durability, the cost of repairs and the burdensome reprocessing steps of ureteroscopy...
2016: J Endourol Case Rep
Wayne Brisbane, Michael R Bailey, Mathew D Sorensen
Kidney stone imaging is an important diagnostic tool and initial step in deciding which therapeutic options to use for the management of kidney stones. Guidelines provided by the American College of Radiology, American Urological Association, and European Association of Urology differ regarding the optimal initial imaging modality to use to evaluate patients with suspected obstructive nephrolithiasis. Noncontrast CT of the abdomen and pelvis consistently provides the most accurate diagnosis but also exposes patients to ionizing radiation...
August 31, 2016: Nature Reviews. Urology
Timur Erk
Founded in 1985, the Turkish Kidney Foundation serves the society with 3 dialysis centers and a 113-bed general hospital. Interacting with public authorities and advocating end-stage renal disease (ESRD) patients' rights are essential services of this non-governmental organization (NGO). Over the last 30 years, keeping with the trend of chronic kidney disease (CKD) in the country, the foundation raised awareness in the population for this condition and prepared an activity road map by using statistical facts and data...
July 29, 2016: Clinical Nephrology
Mary Lynn Davis-Ajami, Jeffery C Fink, Jun Wu
BACKGROUND: Nephrotoxic medication exposure increases risks for acute kidney injury, permanent renal function loss, and costly preventable adverse drug events. Exposure to medications associated with inducing acute tubular nephritis or tubular toxicity versus nonexposure among those with predialysis renal disease-a population vulnerable to increased risk of kidney injury-may affect health services utilization and cost outcomes. Few studies quantify nephrotoxic medication exposure in chronic kidney disease (CKD) and associated costs...
August 2016: Journal of Managed Care & Specialty Pharmacy
Baris Afsar, Murat C Kiremit, Alan A Sag, Kayhan Tarim, Omer Acar, Tarik Esen, Yalcin Solak, Adrian Covic, Mehmet Kanbay
The prevalence of nephrolithiasis has doubled over the last decade and the incidence in females now approaches that of males. Since dietary salt is lithogenic, a purported mechanism common to both genders is excess dietary sodium intake vis-a-vis processed and fast foods. Nephrolithiasis has far-reaching societal implications such as impact on gross domestic product due to days lost from work (stone disease commonly affects working adults), population-wide carcinogenic diagnostic and interventional radiation exposure (kidney stone disease is typically imaged with computed tomographic imaging and treated under imaging guidance and follow-up), and rising healthcare costs (surgical treatment will be indicated for a number of these patients)...
July 19, 2016: European Journal of Internal Medicine
Win Shun Lai, James Ellenburg, Mark E Lockhart, Peter N Kolettis
OBJECTIVE: To assess the costs associated with incidental extraurinary findings on computed tomography urogram (CTU) in patients with asymptomatic microscopic hematuria. MATERIALS AND METHODS: A retrospective review was performed to identify all CTUs performed for asymptomatic microscopic hematuria at our institution from 2012 to 2014. All genitourinary (GU) and incidental extraurinary findings were documented. Further clinical follow-up to May 2015 was reviewed to determine if any referrals, tests, imaging, and/or procedures were ordered based on the initial CTU...
September 2016: Urology
Heon Yung Gee, Ikhyun Jun, Daniela A Braun, Jennifer A Lawson, Jan Halbritter, Shirlee Shril, Caleb P Nelson, Weizhen Tan, Deborah Stein, Ari J Wassner, Michael A Ferguson, Zoran Gucev, John A Sayer, Danko Milosevic, Michelle Baum, Velibor Tasic, Min Goo Lee, Friedhelm Hildebrandt
Nephrolithiasis, a condition in which urinary supersaturation leads to stone formation in the urinary system, affects about 5%-10% of individuals worldwide at some point in their lifetime and results in significant medical costs and morbidity. To date, mutations in more than 30 genes have been described as being associated with nephrolithiasis, and these mutations explain about 15% of kidney stone cases, suggesting that additional nephrolithiasis-associated genes remain to be discovered. To identify additional genes whose mutations are linked to nephrolithiasis, we performed targeted next-generation sequencing of 18 hypothesized candidate genes in 348 unrelated individuals with kidney stones...
June 2, 2016: American Journal of Human Genetics
Jen-Chieh Wang, Yufeng Zhou
Shock wave lithotripsy (SWL) has been used widely in urology for about three decades to treat kidney calculi. Technical development to improve performance (i.e., stone fragmentation efficiency) is continuous. Low-pressure wide-focus lithotripters have already achieved promising results. In this study, the lithotripter field and profile of lithotripter shock waves were changed simultaneously using a cost-effective and convenient design. An intact parabolic reflector was split into four pieces, and each part was moved individually...
August 2016: Ultrasound in Medicine & Biology
Alireza Aminsharifi, Dariush Irani, Mansour Masoumi, Bahman Goshtasbi, Amirhossein Aminsharifi, Reza Mohamadian
The objective of this study was to analyze the outcome of percutaneous nephrolithotomy (PCNL), laparoscopic and open anatrophic nephrolithotomy (AN) for management of patients with large staghorn renal stones. We analyzed the peri-operative parameters, overall treatment costs and changes in the function of the affected kidney on technetium-99 dimercaptosuccinic acid renal scintigraphy, done before the operation and before the final follow-up visit, in 45 adults who underwent PCNL (n = 16) versus laparoscopic (n = 15) versus open (n = 14) AN for large staghorn renal stones...
March 31, 2016: Urolithiasis
Conor P Moran, Aisling E Courtney
Nephrolithiasis, or renal stone disease, is common and the incidence is increasing globally. In the UK the lifetime risk is estimated to be 8-10%. On a population level, the increase in stone incidence, erosion of gender disparity, and younger age of onset is likely to reflect increasing prevalence of obesity and a Western diet with a high intake of animal protein and salt. Stones can be detected by a variety of imaging techniques. The gold standard is a non-contrast CT of kidneys, ureters and bladder (CT KUB) which can identify > 99% of stones...
February 2016: Practitioner
Joel E Abbott, Samuel G Deem, Natalie Mosley, Gary Tan, Nathan Kumar, Julio G Davalos
OBJECTIVE: The objective was to demonstrate that percutaneous nephrolithotomy (PCNL) can be safely performed with a tubeless or totally tubeless drainage technique. INTRODUCTION: Standard PCNL includes nephrostomy tube placement designed to drain the kidney and operative tract at the conclusion of the procedure. Modern technique trend is tubeless PCNL and totally tubeless PCNL, which are performed without standard nephrostomy drainage. We aim to reinforce current literature in demonstrating that PCNL can be safely performed using a tubeless technique...
January 2016: Urology Annals
Joy Melnikow, Guibo Xing, Ginger Cox, Paul Leigh, Lisa Mills, Diana L Miglioretti, Michelle Moghadassi, Rebecca Smith-Bindman
BACKGROUND: Decreasing the use of high-cost tests may reduce health care costs. OBJECTIVE: To compare costs of care for patients presenting to the emergency department (ED) with suspected kidney stones randomized to 1 of 3 initial imaging tests. RESEARCH DESIGN: Patients were randomized to point-of-care ultrasound (POC US, least costly), radiology ultrasound (RAD US), or computed tomography (CT, most costly). Subsequent testing and treatment were the choice of the treating physician...
April 2016: Medical Care
Thomas Knoll, Noor Buchholz, Gunnar Wendt-Nordahl
OBJECTIVES: To review previous reports and discuss current trends in extracorporeal shockwave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and ureterorenoscopy (URS). ESWL was recommended as the first-line treatment for small and intermediate-sized stones in the lower pole, while it is the standard treatment for large stones. However, the stone clearance rate after ESWL seems to be lower than that of stones in other locations. This seems to result from a lower rate of fragment passage, due to anatomical factors...
September 2012: Arab Journal of Urology
Eugene Kramolowsky, Zachary McDowell, Blake Moore, Brigette Booth, Nada Wood
INTRODUCTION: The frequency of flexible ureteroscopy has increased with the introduction of improved instrumentation. Ureteroscopes allow increased endoscopic access to the ureter and kidney. However, maintenance and repair of scopes may increase the total procedure expense. METHODS: In 3 years (8/2011-7/2014), 655 flexible ureteroscopies were performed at a single-specialty, urology, ambulatory surgery center. Procedures were performed by 26 board-certified urologists using four Olympus URF P5 flexible ureteroscopes...
March 2016: Journal of Endourology
Mohammed Hassan, Ahmed R El-Nahas, Khaled Z Sheir, Nasr A El-Tabey, Ahmed M El-Assmy, Ahmed M Elshal, Ahmed A Shokeir
OBJECTIVE: To compare the efficacy, safety and cost of extracorporeal shockwave lithotripsy (ESWL) and percutaneous nephrolithotomy (PNL) for treating a 20-30 mm single renal pelvic stone. PATIENTS AND METHODS: The computerised records of patients who underwent PNL or ESWL for a 20-30 mm single renal pelvic stone between January 2006 and December 2012 were reviewed retrospectively. Patients aged <18 years who had a branched stone, advanced hydronephrosis, a solitary kidney, anatomical renal abnormality, or had a surgical intervention within the past 6 months were excluded...
September 2015: Arab Journal of Urology
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